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General NPI Number Information
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NPI Number | 1134628506
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Entity Type | Organization
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Legal Business Name | THE DOLPHIN MEDICAL CENTER, INC
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 02/12/2018
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Provider Practice Location Address
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Address Line | 1460 NW 107TH AVE STE A
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City | SWEETWATER
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State | FL
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Zip | 33172-2733
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Country | US
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Telephone | 305-887-2252
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Fax | 786-693-8488
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Provider Business Mailing Address
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Address Line | 1460 NW 107TH AVE STE A
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City | SWEETWATER
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State | FL
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Zip | 33172-2733
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Country | US
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Telephone | 305-887-2252
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Fax | 786-693-8488
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HUGO LLANES JR.
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Credential | MEDICAL DOCTOR
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Telephone | 305-887-2252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0068077
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License Number State | FL
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